why do I have shortness of breath Knowing your breathing is abnormal is not entirely straightforward. So, let me explain. we talk about How do I know if my shortness of breath is serious? Is it normal to have some shortness of breath? What triggers shortness of breath?
We're not normally conscious of our breathing. We just breathe and we don't think about it. But one can become aware of your breathing fairly easily and we do this in everyday life.
So, for example, now that we're talking about breathing, you're probably aware of your breathing, or if you run for a bus, this is not a normal level of exercise for you, so you usually become quite conscious of your breathing; if you do something like that.
One can become very abnormally aware of his breathing, either because you're in an abnormal situation or because there's something wrong with the heart or lungs.
why do I have shortness of breath?
if we think of abnormal situations, if you're running for your life, you actually use up or exceed the ability of your heart and lungs even though they're perfectly normal to get oxygen to your muscles, so you can come very distressed and quite frightened because you feel that you're dying from lack of breath in situations like that. We also have a very powerful instinct that if we are very afraid, if we're very fearful, we become very aware of our breathing.
- So, if you have something to do try to hide from bad people or bad animals or something of that kind, we can just become very aware of our breathing because we're frightened.
- This can cause confusion because obviously if anxiety can cause breathing problems or become aware of your breathing, you can equally, in people who are breathless, become very anxious, and knowing which is a chicken and which is the egg, in that situation can take some unpicking.
- So, in general, terms, if you want to talk about abnormal breathing and abnormal body conditions that cause breathing problems, we're looking at sudden or rapid onset acute breathlessness, so this is where over a period of minutes or days one becomes very distressed by one's breathing.
- And this can be very obvious. You can feel that there's a tightness in your chest that you can't expand, you can feel that you're suffocating or you can come panicked by breathing. And all of those could be signs that there's something really significant going on.
- But you can just simply become aware of your breathing is heavy because you got a bad cold. The more subtle one is what we call chronic breathlessness. So, this is something that's happened over weeks or months and you've lost the ability to exercise normally.
So, something that you've been able to do last year, you can no longer do because the breathing stops you. And it's being aware that the breathing stops you is the difficult bit.
Is dyspnea dangerous?
We have a natural tendency to try and reduce our level of effort so that we don't become breathless. And therefore, one can just simply feel that one's getting unfit. And it's sometimes only after you query and dig into the reason why somebody is not exercising that you find they're doing that to avoid becoming breathless. We need to think of things like thyroid disease.
Because if the thyroid is severely overactive, the muscles can demand more oxygen than your heart and lungs could provide.
And then we need to think of things like kidney disease because kidney problems can cause an inability to get rid of fluids from the body, which builds up pressure in the lungs and causes high blood pressure, which can put more pressure on the heart, so a normal lung and heart can be asked to do too much. So those things need to be kept in mind, but actually, what we're generally thinking about are the lungs and the heart.
Now, when it comes to trying to unpick what is going on with the lungs and the heart, we tend to try and divide breathlessness into how rapidly it's come on. So, we have what we call acute breathlessness. Its rapid onset, either appeared today or appeared in the last few days.
And we have chronic breathlessness, that which is occurred slowly over a period of time. And generally talking, there are about weeks or months. So, if we start with the acute, we need to think about the lungs and what's going on with the lungs, and then infection of the lungs would be a very common reason for someone to become breathless over a short period of time.
So, a common cold, the flu or bronchitis, or pneumonia, all of these can cause significant breathlessness. We also need to think about asthma.
What causes shortness of breath?
Because asthma often causes sudden severe constriction of the airways which makes you acutely breathless which normally you can manage quite well. In the heart, we need to think about acute heart failure.
So, a heart that was working pretty well yesterday, and it what you wanted it to do, and now suddenly isn't able to do that. And the kinds of things that can cause that would be a heart attack. So, if you suddenly block off the blood supply to your heart and the heart becomes so weak that you can no longer keep your lungs free of fluid, that would make you very breathless indeed.
Or a severe rhythm problem. If you have a very rapid heart rate, the heart can't function satisfactorily and can make you very breathless. And finally, sometimes an infection in the heart can cause a valve to suddenly rupture, and then the heart becomes inefficient. So acute-severe problems need to be thought about, sometimes acute-mild problems.
We also need to think about lung tissues.
- So smoking damage and other damage can cause emphysema; which means that you can't-- although you can get the air into the lungs, you can't get it efficiently through the blood. Or scarring conditions of the lungs which are called pulmonary fibrosis.
- The final group to actually think about is acute and chronic. And this is where you've got a weakened lung or a weakened heart. That means that you're normally somewhat breathless, but you've lost a lot of reserves.
- So in that situation, a very minor change can suddenly result in severe breathlessness. And finally, somebody with a weakened heart that has a minor rhythm problem that other people would just get some palpitations from, can become severely breathless.
- Clearly, a worry if one develops sudden severe breathlessness. And if that's associated with other things like, you know, fear, feeling panicked, feeling like you're suffocating, the feeling of inability to expand your chest, that's obviously a worry.
- And we're going to look for things like, are you having an acute asthma attack, have you developed acute heart failure, is there an abnormal rhythm that's going on here, have you collapsed a lung, have you a bit of a clot in your lung?
So, a sudden severe breathlessness obviously would be something that one has to take a big interest in. On the other hand, one can also have a more gradual onset of breathlessness.
That also needs to be investigated and should be worried about. And in essence here, the story is, what do you normally do, and are you able to do much that you could do last month or last year? But if you're doing the same sort of exercise that you did last year: walking the dog, going uphill and now you can't do that, that's a clear change.
And I'd say one has to be very careful. We don't often notice that it's due to breathlessness. You feel that you're getting unfit, you feel that you're getting old, you feel that you've put on weight, and all sorts of excuses are generated to say, "I think this might not be real".
What causes acute dyspnea or shortness of breath?
In terms of the lungs, one might notice a cough or producing phlegm. So, it's mucus from the chest.
Or you might notice coughing up blood. So, signs like that will tell you that there's something much more going on than just breathlessness. A persistent new cough can often indicate some scarring in the chest which is very important.
- Blood is always very serious and should be investigated. Chest discomfort particularly when you're breathing in is often a sign that breathing is serious and of course even with short-term breathlessness, if you've got a temperature or sweating at night, that could indicate there's an infection underlying this.
- So, breathlessness at rest is usually a bad sign and we tend to take that very seriously. Certainly, if you find yourself fighting for breath and very worried, call 999. There's nothing else to do other than get it sorted out.
- There are situations where you might be used to being very breathless and having episodes of breathlessness at rest. So, for example, somebody who's got severe asthma, somebody who's got severe lung or heart disease, we may be at the limits of our treatments.
- This may be well known to you and you may have been advised what to do in order to relieve the symptoms at home rather than necessarily rush to the hospital. That's clearly a very specific set of circumstances.
- The second thing to think about is that you can become aware of your breathing at rest and it doesn't necessarily mean that it's an abnormal situation. So, for example, a sense that I want to take a deep breath in and I need to fill my lungs every now and again is not necessarily a bad sign. That's often just a variation on a yawn.
- If you become aware of your breathing because somebody else is pointed it out to you, that's not necessarily an abnormal situation. And if you have an anxiety attack or a panic attack for any reason, then if you become breathless subsequently as part of that, that's acceptable. So, sometimes it'll be difficult to unpick, but generally severe breathlessness at rest, you need to take it very seriously - always.
- Very frequently I answer that question as yes. One does need a second opinion because it's often an excuse rather than analyzing what's really going on.
- So, if you take the weight for starters, plenty of people are overweight. It's not necessarily good for their health, but it doesn't tend to cause breathlessness. It causes fatigue from effort or causes joint pains.
- As a consequence, a lot of people do stop exercising and over a period of time also lose fitness. So, losing fitness can gradually cause you to be unable to exercise and breathless if you try to exercise.
- So, as I previously mentioned, if you significantly reduce your exercise to a low level and then try to exercise more, you'll often notice that there's breathlessness when you do that.
- But if you have been doing your normal things and at this current weight, or relatively similar weight, you suddenly find you can't do what you were doing, then that is real breathlessness. That's not due to the weight. When it comes to age, there certainly is a gradual loss of one's fitness as you get older. So, between the ages of 60 and 80, one does lose the ability to do things at speed.
- But it's a very gradual thing and most people don't even notice that it's breathlessness because it happens so, so slowly. So, if somebody feels more breathless this year than last year, that is not due to age. Again, some people will keep themselves very fit. Those people should not find they lose fitness while doing the same level of effort.
In terms of lack of exercise as a cause of breathlessness what we're looking for here is that the exercise that you would have previously done and now are not doing is something that you cannot now do when you try to do it.
But if you have been doing the level of exercise you're presently doing, then you should not lose that due to lack of exercise.
Is it normal to have some shortness of breath?
The mnemonic is breathe and we're going to walk through this one by one, starting with b. This will help you think of bacterial causes.
This could include things like pneumonia or bacterial endocarditis, which is an infection involving the heart remember if the infection involves the right side of the heart that infection can spread into the lungs called septic pulmonary emboli, and this may make the shortness of breath even worse.
R will help you think of reactive airway disease. Now, reactive airway disease is a general term, but I think it works well for the purpose of the mnemonic to help you remember all the obstructive pulmonary diseases, so things that cause wheezing bronchoconstriction bronchospasm, and this could include things like COPD, asthma, bronchiolitis, bronchitis, and others.
Now I didn't include it here, but you can also use that r to help you remember restrictive lung disease, so we have obstructive and we also have restrictive - and this will include things like neuromuscular disorders, interstitial, lung disease, obesity, and others. Next is e, and you can use this to help you think of embolism.
This will help you remember a pulmonary embolism, which is an obstruction of the pulmonary arteries. Moving on to this will help. You remember acute coronary syndrome, which will include all the conditions associated with decreased blood flow to the heart, such as a heart attack or myocardial infarction. Usually, this term refers to a spectrum of clinical presentations from either stems or n-stems or unstable angina for the purpose of the mnemonic. This is just to help.
You remember that cardiac causes can lead to shortness of breath too. So don't forget that also included in the I put airway obstruction. I like this because it's a general term that will help you remember any type of airway obstruction. This could be a foreign body aspiration, angioedema, anaphylaxis, and many others. You can use the a.
However, you want I like to use airway obstruction because it encompasses a lot of different things, but if you notice angioedema anaphylaxis aspiration, they all start with a so you can use those instead, if you prefer now, let's move on to t this will help.
You remember a couple different things: tension, pneumothorax, and tamponade. Remember. A pneumothorax is basically a collapsed lung. It's an abnormal collection of air in the pleural cavity between the lungs and chest wall.
Attention pneumothorax is basically a severe form of that in which the positive pressure accumulates. So much it can lead to things like tracheal deviation, mediastinal deviation, or even cardiopulmonary dysfunction, but for the purpose of the mnemonic, the tension. Pneumothorax. Is there just to help you remember pneumothorax in general, and then we have tamponade? This will help you think of both the cardiac tamponade and pericardial effusion.
Remember a pericardial effusion is when fluid builds up in the sac around the heart and then tamponade physiology occurs when that fluid builds up so much it puts pressure on the heart and disrupts the normal pumping function of the heart, and this could lead to inadequate perfusion Of oxygenated blood to tissues and organs, this is a type of obstructive shock of note.
Both pulmonary embolism and attention pneumothorax are also forms of obstructive shock as well. Moving on to age. This will help you remember heart failure, it's both self-explanatory and easy to remember. The last one is e and you can use this to help.
You remember several different things. First, you can think of electrical excitation. This will help you think of arrhythmias, which may include a fast or slow heart rate in irregular or regular rhythm, and this could include things like atrial fibrillation, atrial, flutter, supraventricular, tachycardia, bradycardia, ventricular, tachycardia, and others e can also be used to help.
This will help you think of pulmonary edema, which is fluid buildup in the lungs and lastly, the e can stand for effusion, which will help you think of pleural effusion or fluid buildup around the lungs.
So, as you can tell, this is a great mnemonic to remember some of the main causes of shortness of breath. You may have also noticed that this mnemonic focus is on the thorax, mainly problems with the lungs and heart.
I do want to point out that this is not an extensive list and there are also things outside of the thorax that can lead to shortness of breath as well. But I do think this is a useful mnemonic to help you remember some of the main causes.
What triggers shortness breath?
The causes of breathlessness are complicated and the effects, as you will know, can be devastating. This short film aims to help you to understand what happens when you become breathless.
Understanding breathlessness may give you a start to regaining some control over it and reducing its severity. Breathing is controlled by an area of the brain called the brainstem respiratory complex. This area of the brain works a little bit like a thermostat receiving messages from all parts of the body which tell this Center.
- How active you are, for example, how much you are talking, whether you're laughing, whether you're moving around or eating. It then sends out signals to change the way you breathe in response to what your body needs.
- In some conditions, your lungs may be quite stiff. When you start to breathe, your brain is sent a message immediately, telling it that it's difficult to move air in and out of the lungs. There are a number of reasons that your breathing may become difficult, such as the narrowing of the airways.
- These are the tubes that run between different areas of the lungs fluid buildup inside or outside the lungs or tumors pressing on the lungs or airways. When you breathe in air, your lungs transfer oxygen to your body through the bloodstream, the lungs also remove waste products.
- Carbon dioxide from the body when you breathe out when your lungs are not working properly, you can become breathless because there is a lack of oxygen or too much carbon dioxide in your body I'll the extra work of breathing sends a signal to the brain.
To say your breathing system is not working properly. A period of illness or weight loss can leave your breathing muscles a bit weak, making it harder to breathe.
We know that the brain can sense and respond to the increased effort needed to get the air in and out. The body. Breathlessness has an effect on areas of the brain where you think feel remember and interpret experiences and things that have happened to you and if you have any other questions or so by understanding what is making you frightened and anxious about your breathing, you can reduce The impact of breathlessness, for example, people often find it helpful to know that, even though breathlessness is a horrible experience, breathlessness itself does not actually hurt you, it's very, very common that people do less and less when they become more breathless.
The problem with this is that you become less fit and if you become less fit, then you'll become more breathless with less activity. We have this seen daily,, on this website and in our information sheets, we talked quite a lot about psychological techniques such as relaxation, cognitive, behavioral therapy, and mindfulness.
You can use these approaches to help reduce the impact of breathlessness on your life on this website. You can see a short demonstration of how to use the fan, learn, breathing exercises and positions to help with recovery from breathlessness, and try out a relaxation technique.
You will also see some exercises, which can be very healthy, yes, and although we can't actually change the physical cause of the breathlessness, we can change how you feel and think about your breathlessness and by using these methods, hopefully, you'll feel you've got to control over your Breathlessness so that you'll be able to do more things that you want to do nicely when we are frightened, sad or depressed, there's a lower level than normal of some chemical messengers in our brain. That is why doctors sometimes prescribed tablets such as antidepressants to correct this. Our feelings about life are improved when the chemical balance is corrected in the breathlessness intervention service.
We first use non-drug ways of improving levels of chemical messengers through techniques such as mindfulness and relaxation. You can change your feelings and responses to a frightening situation and help reduce the impact of breathlessness, even when the illness itself cannot be cured.